Complex reconstruction of the diabetic foot and ankle.

Reconstruction of the diabetic foot presents significant challenges for the surgeon. The goals of treatment are correction of deformity as well as elimination of infection, with production of a stable, plantigrade foot. Certainly not all patients with Charcot deformities require reconstruction. Many can be effectively managed with proper shoe modifications with orthoses. Bracing is also effective in providing support and in preventing further deformity. Surgical treatment is indicated for patients with recurrent ulceration or an unstable foot. Reconstruction of the Charcot foot should eliminate deformity and remove "high-pressure" areas of the foot and ankle. Achieving these goals should help prevent ulceration and infection, thereby avoiding the most devastating complication of the Charcot foot: amputation.